布比卡因、利多卡因混合液及布比卡因液行臂丛阻滞的比较

本文比较了应用0.25％布比卡因和1％利多卡因混合液与单纯0.25％布比卡因液进行臂丛神经阻滞的麻醉效果。病人总数80例,分二组进行临床对比。每组又按给药容量(0.4ml/kg或0.6ml/kg)分为两个亚组,观察神经阻滞起效、完善和持续时间。结果使用混合液的一组,阻滞完善时间显著缩短,比较组内两种容量的效应,发现容量大并不能缩短完善时间,但能扩大阻滞范围;小容量却能保存手指轻微自主动作的功能。本混合液神经阻滞作用强,副作用少,混合液0.6ml/kg适用于上臂任何部位的手术及多次臂丛阻滞患者,0.4ml/kg适用于手指肌腱、神经探查术。

Bupivacaine Combined with Lidocaine Versus Bupivacaine Alone: A Comparison of Their Therapeutic Effects in Brachial Plexus Block

The article compared the anesthetic action of mixture of 1% lidocaine and 0.25% bupivacaine solution with 0.25% simple bupivacaine solution. All 80 patients had been studied in two randomized groups. According to the administrated drug volumes (either 0.4ml/kg or 0.6ml/kg), each group was again allocated to two subgroups. The duration of onset, completion and anesthesia persistance on the sensory and motor blockade were observed. The results revealed that the duration of completion in group received mixture solution was significantly shorter than group received simple bupivacaine solution, and no statistic difference on the duration of onset between each group. We found that increasing volume of local anesthetics between the subgroups can't shorten the duration of anesthesia completion, but can extend the blocking area. The patients received smaller volume can keep spontaneous activity of fingers to a certain degree. We consider that mixture solution possesses potent blocking action and less side-effects superior to simple bupivacaine solution. The larger volume of mixture solution (0.6 ml/kg) is better for operations over the upper forearm and the patients with repeated brachial plexus block; the less volume (0.4 ml/kg) is favourable for tenomyoplasty of hand.